Left lobectomy might be a risk factor for atrial fibrillation following pulmonary lobectomy

Eur J Cardiothorac Surg. 2014 Feb;45(2):247-50. doi: 10.1093/ejcts/ezt383. Epub 2013 Aug 6.


Objective: To identify risk factors for atrial fibrillation (AF) following lobectomy for a pulmonary malignant tumour.

Methods: The outcomes of patients who underwent lobectomy from February 2005 to September 2010 were analysed with respect to the development of postoperative AF.

Results: Among 186 patients, 20 developed AF and these had significantly higher preoperative B-type natriuretic peptide (BNP) than those without AF. A significantly high incidence of AF following pulmonary lobectomy was demonstrated in the group of patients who were male, underwent a thoracotomy, had a high preoperative value of BNP and underwent a left lobectomy. Multivariate analysis revealed that left lobectomy is the only independent risk factor. The area under the receiver-operating characteristic curve for BNP to predict postoperative AF following a left lobectomy for a pulmonary malignant tumour was 0.82 (95% confidence interval 0.70-0.93; P<0.05). A BNP level of 24.1 pg/ml had a sensitivity of 90.9% and a specificity of 56% for predicting postoperative AF following left lobectomy for a pulmonary malignant tumour.

Conclusions: Left lobectomy is the only independent risk factor for postoperative AF. Elevated BNP is the risk factor for postoperative AF in patients undergoing left pulmonary lobectomy.

Keywords: Arrhythmia; Atrial fibrillation; B-type natriuretic peptide; Lobectomy; Lung cancer; Surgery.

MeSH terms

  • Aged
  • Atrial Fibrillation / blood
  • Atrial Fibrillation / etiology*
  • Chi-Square Distribution
  • Female
  • Humans
  • Lung Neoplasms / blood
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Natriuretic Peptide, Brain / blood
  • Pneumonectomy / adverse effects*
  • Predictive Value of Tests
  • ROC Curve
  • Risk Factors


  • Natriuretic Peptide, Brain